Behavioral symptoms in residential care/assisted living facilities

Prevalence, risk factors, and medication management

Ann L. Gruber-Baldini, Malaz Boustani, Philip D. Sloane, Sheryl Zimmerman

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

OBJECTIVES: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. DESIGN: Cross-sectional study. SETTINGS: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). PARTICIPANTS: A total of 2,078 RC/AL residents aged 65 and older. MEASUREMENT: Behavioral symptoms were classified using a modified version of the Cohen-Mansfield Agitation Inventory. Additional items on resistance to care were also examined. RESULTS: Approximately one-third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two-thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). CONCLUSION: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long-term setting.

Original languageEnglish
Pages (from-to)1610-1617
Number of pages8
JournalJournal of the American Geriatrics Society
Volume52
Issue number10
DOIs
StatePublished - Oct 2004

Fingerprint

Assisted Living Facilities
Behavioral Symptoms
Psychotic Disorders
Dementia
Depression
Mental Health Services
Activities of Daily Living
Psychiatry
Mental Health

Keywords

  • Agitation
  • Assisted living
  • Behavioral symptoms
  • Dementia
  • Residential care

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Behavioral symptoms in residential care/assisted living facilities : Prevalence, risk factors, and medication management. / Gruber-Baldini, Ann L.; Boustani, Malaz; Sloane, Philip D.; Zimmerman, Sheryl.

In: Journal of the American Geriatrics Society, Vol. 52, No. 10, 10.2004, p. 1610-1617.

Research output: Contribution to journalArticle

@article{156eea11f8d84c32a0b342cf708b5183,
title = "Behavioral symptoms in residential care/assisted living facilities: Prevalence, risk factors, and medication management",
abstract = "OBJECTIVES: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. DESIGN: Cross-sectional study. SETTINGS: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). PARTICIPANTS: A total of 2,078 RC/AL residents aged 65 and older. MEASUREMENT: Behavioral symptoms were classified using a modified version of the Cohen-Mansfield Agitation Inventory. Additional items on resistance to care were also examined. RESULTS: Approximately one-third (34{\%}) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20{\%} demonstrated physically nonaggressive behavioral symptoms, 22{\%} expressed verbal behavioral symptoms, and 13{\%} resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50{\%} of RC/AL residents were taking a psychotropic medication, and two-thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). CONCLUSION: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long-term setting.",
keywords = "Agitation, Assisted living, Behavioral symptoms, Dementia, Residential care",
author = "Gruber-Baldini, {Ann L.} and Malaz Boustani and Sloane, {Philip D.} and Sheryl Zimmerman",
year = "2004",
month = "10",
doi = "10.1111/j.1532-5415.2004.52451.x",
language = "English",
volume = "52",
pages = "1610--1617",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Behavioral symptoms in residential care/assisted living facilities

T2 - Prevalence, risk factors, and medication management

AU - Gruber-Baldini, Ann L.

AU - Boustani, Malaz

AU - Sloane, Philip D.

AU - Zimmerman, Sheryl

PY - 2004/10

Y1 - 2004/10

N2 - OBJECTIVES: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. DESIGN: Cross-sectional study. SETTINGS: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). PARTICIPANTS: A total of 2,078 RC/AL residents aged 65 and older. MEASUREMENT: Behavioral symptoms were classified using a modified version of the Cohen-Mansfield Agitation Inventory. Additional items on resistance to care were also examined. RESULTS: Approximately one-third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two-thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). CONCLUSION: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long-term setting.

AB - OBJECTIVES: To examine the prevalence, correlates, and medication management of behavioral symptoms in elderly people living in residential care/assisted living (RC/AL) facilities. DESIGN: Cross-sectional study. SETTINGS: A stratified random sample of 193 RC/AL facilities in four states (Florida, Maryland, New Jersey, North Carolina). PARTICIPANTS: A total of 2,078 RC/AL residents aged 65 and older. MEASUREMENT: Behavioral symptoms were classified using a modified version of the Cohen-Mansfield Agitation Inventory. Additional items on resistance to care were also examined. RESULTS: Approximately one-third (34%) of RC/AL residents exhibited one or more behavioral symptoms at least once a week. Thirteen percent exhibited aggressive behavioral symptoms, 20% demonstrated physically nonaggressive behavioral symptoms, 22% expressed verbal behavioral symptoms, and 13% resisted taking medications or activities of daily living care. Behavioral symptoms were associated with the presence of depression, psychosis, dementia, cognitive impairment, and functional dependency, and these relationships persisted across subtypes of behavioral symptoms. Overall, behavioral symptoms were more prevalent in smaller facilities. More than 50% of RC/AL residents were taking a psychotropic medication, and two-thirds had some mental health problem indicator (dementia, depression, psychosis, or other psychiatric illness). CONCLUSION: Integrating mental health services within the process of care in RC/AL is needed to manage and accommodate the high prevalence of behavioral symptoms in this evolving long-term setting.

KW - Agitation

KW - Assisted living

KW - Behavioral symptoms

KW - Dementia

KW - Residential care

UR - http://www.scopus.com/inward/record.url?scp=6944224171&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=6944224171&partnerID=8YFLogxK

U2 - 10.1111/j.1532-5415.2004.52451.x

DO - 10.1111/j.1532-5415.2004.52451.x

M3 - Article

VL - 52

SP - 1610

EP - 1617

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 10

ER -